Covered stent

ABSTRACT

A covered stent comprises a coiled sheet stent having at least a portion with open cell geometry and a graft material covering at least a portion of the coiled sheet stent.

BACKGROUND OF THE INVENTION

The use of endoprostheses such as stents, stent-grafts, grafts, etc. iswell known in maintaining the patency of bodily vessels and treatingstenoses within arteries and other body spaces.

Stents can be constructed from tubes or sheets. Of those constructedfrom sheets, rolled and coiled, coiled sheet stents are known in theart. These coiled sheet stent designs have limited geometries to preventtangling of the layers as the stent expands and un-coils. In general,the geometries of these coiled sheet stent designs are typically lessflexible than the geometric stent designs available in other types ofstents.

The coiled sheet stent designs typically have closed cell geometries inorder to avoid tangling whereas some of the more flexible stentstypically have open cell geometries. The closed cells typically havemore connectors connecting adjacent portions of the coiled stenttogether than do the open cell geometries.

However, stent flexibility is very important in certain procedures dueto the tortuous route the stent must make through the circulatory systemin reaching the occlusion site. A concern with stents with “closed cell”geometries is that they will not be flexible enough to conform to thenatural vessel curvature. A concern with stents with “open cell”geometries is the tangling of layers as the stent expands and uncoils atthe site of the occlusion.

It would be desirable to introduce a flexible stent with “open cell”portions that do not experience tangling of the layers as the stentexpands and uncoils into the occlusions area.

All U.S. patents and applications and all other published documentsmentioned anywhere in this application are incorporated herein byreference in their entirety.

Without limiting the scope of the invention a brief summary of some ofthe claimed embodiments of the invention is set forth below. Additionaldetails of the summarized embodiments of the invention and/or additionalembodiments of the invention may be found in the Detailed Description ofthe Invention below.

A brief abstract of the technical disclosure in the specification isprovided as well for the purposes of complying with 37 C.F.R. 1.72.

BRIEF SUMMARY OF THE INVENTION

The present invention is directed to a variety of embodiments, in atleast one embodiment the invention is directed to the combination of acoiled sheet stent with graft material.

In at least one embodiment the graft material is applied as a singlelayer to one surface of the stent sheet.

In another embodiment the covering of graft material is applied as asingle layer on each side of the stent sheet.

In another embodiment the stent sheet is placed inside a tubular graftmaterial. The graft material is then pressed down onto the stent sheet.The tubular shape defined as any shape having a continuous crosssection.

In another embodiment the stent sheet is laid onto one half of a graftmaterial that is approximately twice as large as the stent sheet. Theother half is then folded down to cover the other side of the stentsheet.

In at least one embodiment the graft material is placed over the entirestent sheet.

In another embodiment the graft material is placed over only a portionof the stent sheet.

In another embodiment the graft material is placed over several portionsof the stent sheet.

In another embodiment the graft material delivers a drug.

In still another embodiment the stent sheet delivers a drug.

In at least one embodiment the graft material is selected from the groupconsisting of: ePTFE, Dacron/polyester, fibrin, collagen, andcombinations thereof.

In yet another embodiment, the graft material serves as an electricalinsulator between adjacent layers of the stent sheet.

In yet another embodiment, the invention is directed to a method ofpreventing radially adjacent cells of a coil stent from intertanglingcomprising the steps of providing a stent with a plurality of cells anddisposing a graft material over at least some of the cells so that atleast some cells which are radially adjacent one another are separatedby the graft material, the graft material prevent tangling betweenadjacent layers of the stent. Typically, at least one of the radiallyadjacent cells will be of open cell geometry.

These and other embodiments which characterize the invention are pointedout with particularity in the claims annexed hereto and forming a parthereof. However, for a better understanding of the invention, itsadvantages and objectives obtained by its use, reference should be madeto the drawings which form a further part

BRIEF DESCRIPTION OF THE SEVERAL VIEWS OF THE DRAWING(S)

A detailed description of the invention is hereafter described withspecific reference being made to the drawings.

FIG. 1A is a flat view of a sheet stent having a closed cell geometry.

FIG. 1B is a cross-sectional perspective view of a coiled sheet tubularstent.

FIG. 2 is a flat view of a portion of a coiled sheet stent with bothuncovered closed cell geometries and covered open cell geometries.

FIG. 3 is a perspective view of a sheet stent being pressed between twosheets of graft material, prior to being coiled.

FIG. 4 is a cross-sectional view of a sheet stent inside a tubular graftmaterial, prior to being coiled.

FIG. 5 is a cross-sectional view of a sheet stent being folded inside asingle sheet of tubular graft material, prior to being coiled.

FIG. 6 is a cross-sectional view of a sheet stent showing a portion ofthe graft material between overlapping portions of the coiled sheetstent.

FIG. 7 is a cross-sectional view of a sheet stent showing multiplelayers of the graft material between overlapping layers of the coiledsheet stent.

DETAILED DESCRIPTION OF THE INVENTION

While this invention may be embodied in many different forms, there aredescribed in detail herein specific embodiments of the invention. Thisdescription is an exemplification of the principles of the invention andis not intended to limit the invention to the particular embodimentsillustrated.

For the purposes of this disclosure, like reference numerals in thefigures shall refer to like features unless otherwise indicated.

As indicated above the present invention is directed to a variety ofembodiments. In FIG. 1A a closed cell geometry of sheet stent 12 withlongitudinal axis 18 is illustrated in that the number of interior peaks16 is equal to twice the number of connectors 20. An open cell geometryhas more interior peaks 16 than twice the number of connectors 20.

FIG. 1B is a cross-sectional view of a coiled sheet tubular stent 12having a longitudinal axis 18. The outermost longitudinal edge 22 andthe teeth 24 overlap when the stent sheet 12 is in a tubular form.

As shown in FIG. 2, in some embodiments the graft material 30 coversonly a portion of sheet stent 12. In this figure the graft material 30primarily covers a portion of the stent with open cell geometries 31 andleaves a portion of the closed cell geometries 33 uncovered. This givesthe stent the flexibility of an open cell design without the tangling oflayers that frequently occurs with open cell geometries; particularlywith large cells, unconnected peaks within adjacent cell layers of cellsmay interfere with one another. The distal most edge 32 of the graftmaterial 30 can also be a fold whereby the graft material 30 coversportions on both sides of the sheet stent 12.

As shown in FIG. 3, two graft materials 30A,30B are positioned to coverportions on both sides of sheet stent 12. Graft materials 30A,30B can bemade of identical material or different materials. In some embodiments,graft material 30A does not match 30B in size and/or orientation. Hencesome portion of graft 30A and graft 30B can contact one another withoutsheet stent 12 separating them. In some embodiments, the graft materials30A,30B have no edges extending beyond the sheet stent 12. In otherembodiments, only one or the other of the graft materials 30A,30B haveedges which extend beyond the sheet stent 12. In other embodiments onegraft material has an edge that extends beyond the sheet stent 12 andadditionally folds over onto the other side of sheet stent 12 or foldsover onto the other graft material that is in contact with the sheetstent 12.

As shown in FIG. 4, sheet stent 12 is placed into tubular graft material30C. Tubular graft material 30C is a continuous piece, but may containdifferent materials. Upon being placed in the tubular graft material30C, graft material 30C is collapsed upon sheet stent 12. The tubulargraft material 30 may or may not extend beyond the outside edges of thesheet stent in a latitudinal direction.

As shown in FIG. 5, sheet stent 12 is placed upon a graft material 30Dthat is approximately twice as long or wide as the sheet stent 12. Thegraft material 30D is then folded such that the sheet stent is betweenthe two folded sides of the graft material 30D such that at least aportion of each side of the sheet stent 12 is covered with the graftmaterial 30D. Sheet stent 12 may have both sides completely covered bygraft material 30D or one side completely covered and the other sidepartially covered.

In FIG. 6 the graft material 30E is shown providing a layer between theportions of the sheet stent 12 which overlap. In FIG. 7 multiple layersof overlapping are shown wherein graft material 30E provides a layerbetween the radially overlapping portions of the sheet stent 12. Itshould be noted and evident from the disclosure that graft material mayprovide a layer between any adjacent portions of the sheet stent 12.

The graft material can also be selected so as to provide an electricalinsulator layer between conductive layers of the stent or overlappingportions of the stent or both. This electrical insulator layer may beused to minimize or eliminate the formation of electrical disturbances(e.g. eddy currents) that might otherwise occur when using MagneticResonance Imaging (MRI) to image the stent or the body in which thestent is disposed. Such disturbances can interfere with MagneticResonance Imaging thereby reducing one's ability to visualize portionsof the stent or the surrounding body (e.g. eddy currents may reduce theability to visualize the interior of the stent).

As already indicated, this invention is applicable to self-expandingconfigurations of the stent sheet and mechanically expandableconfigurations of the stent sheet and to stent sheets made from a widevariety of materials, including both metal and plastic and any othermaterial capable of functioning as an expandable stent. It may bethin-walled or thick walled. It may be of shape memory alloy such asNitinol or the like, etc or of stainless steel, titanium or any othersuitable, biocompatible metal as known in the art.

The inventive stents may also be provided with various bio-compatiblecoatings to enhance various properties of the stent. For example, theinventive stents may be provided with lubricious coatings. The inventivestents may also provide drug release over time. This release of drugsover time may be provided through drug-containing coatings, or directimplantation of a drug onto or into the graft, or drug-containingcoatings applied prior to applying the graft material. The graftmaterial may also be used to deliver a drug.

The inventive stents may also be provided with a sugar or more generallya carbohydrate and/or a gelatin to maintain the stent on a balloonduring delivery of the stent to a desired bodily location. Othersuitable compounds for treating the stent include biodegradable polymersand polymers which are dissolvable in bodily fluids. Portions of theinterior and/or exterior of the stent may be coated or impregnated withthe compound. Mechanical retention devices may also be used to maintainthe stent on the balloon or delivery catheter during delivery. To thatend, the use of other coatings on the inventive stents is also withinthe scope of the invention.

The coating may comprise one or more non-genetic therapeutic agents,genetic materials and cells and combinations thereof as well as otherpolymeric coatings.

Non-genetic therapeutic agents include anti-thrombogenic agents such asheparin, heparin derivatives, urokinase, and PPack (dextrophenylalanineproline arginine chloromethylketone); anti-proliferative agents such asenoxaprin, angiopeptin, or monoclonal antibodies capable of blockingsmooth muscle cell proliferation, hirudin, and acetylsalicylic acid;anti-inflammatory agents such as dexamethasone, prednisolone,corticosterone, budesonide, estrogen, sulfasalazine, and mesalamine;antineoplastic/antiproliferative/anti-miotic agents such as paclitaxel,5-fluorouracil, cisplatin, vinblastine, vincristine, epothilones,endostatin, angiostatin and thymidine kinase inhibitors; anestheticagents such as lidocaine, bupivacaine, and ropivacaine; anticoagulantssuch as D-Phe-Pro-Arg chloromethyl keton, an RGD peptide-containingcompound, heparin, antithrombin compounds, platelet receptorantagonists, antithrombin anticodies, anti-platelet receptor antibodies,aspirin, prostaglandin inhibitors, platelet inhibitors and tickantiplatelet peptides; vascular cell growth promotors such as growthfactor inhibitors, growth factor receptor antagonists, transcriptionalactivators, and translational promotors; vascular cell growth inhibitorssuch as growth factor inhibitors, growth factor receptor antagonists,transcriptional repressors, translational repressors, replicationinhibitors, inhibitory antibodies, antibodies directed against growthfactors, bifunctional molecules consisting of a growth factor and acytotoxin, bifunctional molecules consisting of an antibody and acytotoxin; cholesterol-lowering agents; vasodilating agents; and agentswhich interfere with endogenous vascoactive mechanisms.

Genetic materials include anti-sense DNA and RNA, DNA coding for,anti-sense RNA, tRNA or rRNA to replace defective or deficientendogenous molecules, angiogenic factors including growth factors suchas acidic and basic fibroblast growth factors, vascular endothelialgrowth factor, epidermal growth factor, transforming growth factor.alpha. and .beta., platelet-derived endothelial growth factor,platelet-derived growth factor, tumor necrosis factor .alpha.,hepatocyte growth factor and insulin like growth factor, cell cycleinhibitors including CD inhibitors, thymidine kinase (“TK”) and otheragents useful for interfering with cell proliferation the family of bonemorphogenic proteins (“BMP's”),BMP-2, BMP-3, BMP-4, BMP-5, BMP-6(Vgr-1), BMP-7 (OP-1), BMP-8, BMP-9, BMP-10, BMP-11, BMP-12, BMP-13,BMP-14, BMP-15, and BMP-16. Desirable BMP's are any of BMP-2, BMP-3,BMP-4, BMP-5, BMP-6 and BMP-7. These dimeric proteins can be provided ashomodimers, heterodimers, or combinations thereof, alone or togetherwith other molecules. Alternatively or, in addition, molecules capableof inducing an upstream or downstream effect of a BMP can be provided.Such molecules include any of the “hedgehog” proteins, or the DNA'sencoding them.

Cells can be of human origin (autologous or allogeneic) or from ananimal source (xenogeneic), genetically engineered if desired to deliverproteins of interest at the transplant site. The cells may be providedin a delivery media. The delivery media may be formulated as needed tomaintain cell function and viability.

Suitable polymer coating materials include polycarboxylic acids,cellulosic polymers, including cellulose acetate and cellulose nitrate,gelatin, polyvinylpyrrolidone, cross-linked polyvinylpyrrolidone,polyanhydrides including maleic anhydride polymers, polyamides,polyvinyl alcohols, copolymers of vinyl monomers such as EVA, polyvinylethers, polyvinyl aromatics, polyethylene oxides, glycosaminoglycans,polysaccharides, polyesters including polyethylene terephthalate,polyacrylamides, polyethers, polyether sulfone, polycarbonate,polyalkylenes including polypropylene, polyethylene and high molecularweight polyethylene, halogenated polyalkylenes includingpolytetrafluoroethylene, polyurethanes, polyorthoesters, proteins,polypeptides, silicones, siloxane polymers, polylactic acid,polyglycolic acid, polycaprolactone, polyhydroxybutyrate valerate andblends and copolymers thereof, coatings from polymer dispersions such aspolyurethane dispersions (for example, BAYHDROL.RTM.), fibrin, collagenand derivatives thereof, polysaccharides such as celluloses, starches,dextrans, alginates and derivatives, hyaluronic acid, squaleneemulsions. Polyacrylic acid, available as HYDROPLUS.RTM. (BostonScientific Corporation, Natick, Mass.), and described in U.S. Pat. No.5,091,205, the disclosure of which is hereby incorporated herein byreference, is particularly desirable. Even more desirable is a copolymerof polylactic acid and polycaprolactone.

Other suitable coverings include nylon, collagen, PTFE and expandedPTFE, polyethylene terephthalate and KEVLAR, or any of the materialsdisclosed in U.S. Pat. Nos. 5,824,046 and 5,755,770. More generally, anyknown graft material may be used including synthetic polymers such aspolyethylene, polypropylene, polyurethane, polyglycolic acid,polyesters, polyamides, their mixtures, blends and copolymers.

The stents may find use in coronary arteries, renal arteries, peripheralarteries including iliac arteries, arteries of the leg, aorta, arteriesof the neck and cerebral arteries. The stents of the present invention,however, are not limited to use in the vascular system and may also beadvantageously employed in other body structures, including but notlimited to arteries, veins, biliary ducts, urethras, fallopian tubes,bronchial tubes, the trachea, the esophagus and the prostate. Theinventive stent may be delivered on a catheter such as that discussed inWO 01/01885.

The stent sheets used in the inventive covered stents disclosed hereinmay be manufactured using any suitable known technique for manufacturingstent sheets including laser cutting or mechanically cutting a stentpattern in a sheet of material, etching, chemically or otherwise, astent pattern in a sheet of material, or using an EDM (electricaldischarge machining) technique to cut a stent pattern into a sheet ofmaterial.

The above examples and disclosure are intended to be illustrative andnot exhaustive. These examples and description will suggest manyvariations and alternatives to one of ordinary skill in this art. Allthese alternatives and variations are intended to be included within thescope of the attached claims. Those familiar with the art may recognizeother equivalents to the specific embodiments described herein whichequivalents are also intended to be encompassed by the claims attachedhereto.

1. A covered stent comprising: a coiled sheet stent having a cylindricallumen, said coiled sheet stent having a plurality of radiallyoverlapping sections at least one of which includes an open cellgeometry portion having at least two rows of interior peaks, at leastone of said interior peaks in each of said rows being disconnected fromsaid interior peaks in the other of said rows; and a graft materialcovering at least a portion of said open cell geometry portion so thatsaid graft material is between said radially overlapping sections toseparate said at least one of said peaks which is disconnected from theother said peaks from said another of said radially overlappingsections.
 2. The covered stent of claim 1, wherein the graft materialcovers the entire coiled sheet stent.
 3. The covered stent of claim 1,wherein said graft material is located on only one side of said coiledsheet stent.
 4. The covered stent of claim 1, wherein the graft materialentirely covers only one side of the coiled sheet stent.
 5. The coveredstent of claim 1, wherein the graft material is located on an interiorside and an exterior side of the coiled sheet stent.
 6. The coveredstent of claim 5, wherein the graft material entirely covers theinterior side of the coiled sheet stent and less than the entirety ofthe exterior side of the coiled sheet stent.
 7. The covered stent ofclaim 5, wherein the graft material entirely covers an exterior side ofthe coiled sheet stent and less than the entirety of the interior sideof the coiled sheet stent.
 8. The covered stent of claim 1, wherein saidgraft material covers a portion of one side of said coiled sheet stentand folds over a portion of a second side of said coiled sheet stent. 9.The covered stent of claim 1, wherein the graft material is tubular andthe stent is placed inside the graft material such that a portion of afirst and a portion of a second side are covered.
 10. The covered stentof claim 1, wherein said graft material covers portions of said coiledsheet stent that have closed cell geometries.
 11. The covered stent ofclaim 1, wherein said graft material covers portions of said coiledsheet stent having open cell geometries and portions of said coiledsheet stent having closed cell geometries.
 12. The covered stent ofclaim 1, wherein there is a plurality of layers with graft materialbetween multiple layers.
 13. The covered stent of claim 12, wherein thegraft material is constructed of MRI compatible material.
 14. Thecovered stent of claim 12 wherein the graft material acts as anelectrical insulator between conductive layers of the stent.
 15. Thecovered stent of claim 1, having the graft material between cells whichare radially adjacent.
 16. The covered stent of claim 1, said coiledsheet stent including a set of radial cells, wherein at least one ofsaid radial cells is an open cell.
 17. The covered stent of claim 1,wherein said graft material covers at least one cell having one or moreunconnected peaks.
 18. The covered stent of claim 17, wherein said graftmaterial covers a plurality of cells having unconnected peaks.
 19. Thecovered stent of claim 1, wherein the stent delivers a drug of medicinalvalue.
 20. The covered stent of claim 19, wherein said drug is coated onthe stent.
 21. The covered stent of claim 19, wherein said drug iscontained in the stent.
 22. The covered stent of claim 1, wherein saidgraft material delivers a drug.
 23. The covered stent of claim 22,wherein said drug is coated on said graft material.
 24. The coveredstent of claim 22, wherein said drug is contained in said graftmaterial.
 25. A method of preventing radially adjacent cells of a coilstent from intertangling, the method comprising the steps of: 1)providing a coiled sheet stent having a cylindrical lumen, said coiledsheet stent having a plurality of radially overlapping sectionsincluding a plurality of cells, at least one of said radiallyoverlapping sections including an open cell geometry portion having atleast two rows of interior peaks, at least one of said interior peaks ineach of said rows being disconnected from said interior peaks in theother of said rows; and 2) disposing a graft material with an open seamover at least said open cell geometry portion, so that said graftmaterial is between said radially overlapping sections to separate saidat least one of said peaks which is disconnected from the other saidpeaks from said another of said radially overlapping portions.
 26. Themethod of claim 25 wherein said open cell geometry of at least one ofsaid radially overlapping portions is configured to provide a dual modeof expansion.
 27. A covered stent comprising: an expandable coiled sheetstent having a longitudinal axis, said coiled sheet stent including anopen cell geometry portion defined by a web filament interconnected viastrut connectors, and arranged substantially along said longitudinalaxis in an alternating zigzag direction without crossing over anothersection of said filament, said filament incorporating two parallel andadjacent interior peaks distinguished by acute angular shapes ofchanging directions unrestrained by said strut connectors, said filamentincorporating a plurality of additional interior peaks and one of saidadjacent interior peaks arranged in a row, said additional interiorpeaks being joined to one another and to said one of said adjacentinterior peaks by a plurality of respective regions of said filamentwhich are curved to define concave and convex surfaces, said adjacentand additional interior peaks being arranged in said row such that saidconcave and convex surfaces have alternating locations relative to oneanother; and a graft material having an open seam parallel to saidlongitudinal axis, said graft material draping over at least an externalportion of said open cell geometry portion, wherein said coiled sheetstent is rolled into a tubular shape.
 28. The covered stent of claim 27,wherein the covered stent includes dual mode of expansion, a firstexpansion mode being defined by straightening feature of said filamentinterconnected via strut connectors, and a second further expansion modebeing defined by twisting of said two adjacent interior peaks withinsaid graft material.